Editing Infective endocarditis (section)

===Modified Duke criteria===
Established in 1994 by the Duke Endocarditis Service and revised in 2000, the Duke criteria are a collection of major and minor criteria used to establish a diagnosis of infective endocarditis.<ref name="Durack"/><ref name="Li2000">{{cite journal | vauthors = Li JS, Sexton DJ, Mick N, Nettles R, Fowler VG, Ryan T, Bashore T, Corey GR | title = Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis | journal = Clinical Infectious Diseases | volume = 30 | issue = 4 | pages = 633–8 | date = April 2000 | pmid = 10770721 | doi = 10.1086/313753 | doi-access = free }}</ref> According to the Duke criteria, diagnosis of infective endocarditis can be definite, possible, or rejected.<ref name="NEJM Review, Hoen" /> A diagnosis of infective endocarditis is definite if either the following pathological ''or'' clinical criteria are met:

One of these pathological criteria:
* Histology or culture of cardiac vegetation, embolized vegetation, or intracardiac abscess from the heart finds microorganisms
* Active endocarditis
One of these combinations of clinical criteria
* Two major clinical criteria
* One major and three minor criteria
* Five minor criteria
Diagnosis of infective endocarditis is possible if one of the following combinations of clinical criteria is met:
* One major and one minor criteria
* Three minor criteria are fulfilled

====Major criteria====
Positive blood culture with typical IE microorganism, defined as one of the following:<ref name="NEJM Review, Hoen" />
* Typical microorganism consistent with IE from two separate blood cultures, as noted below:
** [[Streptococcus viridans|Viridans-group streptococci]], or
** ''[[Streptococcus bovis]]'' including nutritional variant strains, or
** [[HACEK]] group, or
** ''[[Staphylococcus aureus]]'', or
** Community-acquired ''[[enterococci]]'', in the absence of a primary focus
* Microorganisms consistent with IE from persistently positive blood cultures defined as:
** Two positive cultures of blood samples drawn >12 hours apart, or
** Three or a majority of ≥four separate blood cultures (with first and last sample drawn at least one hour apart)
** ''[[Coxiella burnetii]]'' detected by at least one positive blood culture or [[IgG antibody]] titer for [[Q fever]] phase 1 antigen >1:800. This was previously a minor criterion
Evidence of endocardial involvement with positive echocardiogram is defined as
* Oscillating intracardiac mass on valve or supporting structures, in the path of regurgitant jets, or on implanted material in the absence of an alternative anatomic explanation, or
* Abscess, or
* New partial dehiscence of prosthetic valve or new valvular regurgitation (worsening or changing of preexisting murmur not sufficient)

====Minor criteria====
* Predisposing factor: known cardiac lesion, recreational [[drug injection]]
* Fever >38&nbsp;°C
* [[Embolism|Vascular]] phenomena: arterial emboli, [[lung|pulmonary]] [[infarct]]s, [[Janeway lesions]], [[conjunctiva]]l hemorrhage
* Immunological phenomena: [[glomerulonephritis]], [[Osler's nodes]], [[Roth's spots]], [[Rheumatoid factor]]
* Microbiologic evidence: Positive blood culture (that doesn't meet a major criterion) or serologic evidence of infection with organism consistent with IE but not satisfying major criterion
'''Updated (2023) Modified Duke Criteria for Infective Endocarditis:''' Infective endocarditis (IE) is a life-threatening condition and the Duke criteria (established in 1994 and revised in 2000) has been fundamental for the diagnosis of the disease. However, the landscape of micro-biology, diagnostics, epidemiology, and treatment for lE has evolved significantly over the years. The 2023 modified Duke criteria address these changes: [https://medicalstudyhub.com/updated-2023-modified-duke-criteria-for-infective-endocarditis/ Updated (2023) Modified Duke Criteria for Infective Endocarditis]